• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.34-38
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• 2017

Purpose During PET/CT examinations, the movements of internal organs caused by respiration are captured in images during multiple breathing cycles, resulting in the increases in tumor size and effects on SUV. Respiratory synchronized systems were used to evaluate tumor sizes and SUV changes. Materials and Methods Biograph mCT 64 was used for the equipment, and RPM and Anzai systems were used for the respiratory synchronized systems. We used point source and micro-phantom for an experimentation. We were performed on 12 patients who had solid tumors discovered at the base of the lung or at the top of the liver from August through September 2016. The PET images of the exhalation-to-breathing state and the CT images of the post-exhalation suspension state were gained to evaluate changes in radioactivity concentration (KBq/mL), SUVmax, cylinder diameter (mm), and tumor diameter (cm) under the conventional Static, RPM, and Anzai methods. Results The result of measuring the radioactivity concentration of the point source was RPM 94% and Anzai 91% against Static, respectively. In the two cylinders of different radioactivity in the micro-phantom, the SUVmax increased to RPM 61% and 78%, and Anzai 58% and 77% against Static, whereas the cylinder diameters decreased by RPM -26% and -28%, and Anzai -28% and -26%, each respectively. Among the patients, the SUVmax increased from a minimum of RPM 8.2% to a maximum of 94.4% against Static, and from a minimum of Anzai 7.6% to a maximum of 68.3%, respectively. As for the tumor diameters, a minimum of RPM -7.6% to a maximum of -28.9% were achieved, while the Anzai fell by a minimum of -9.6% to a maximum of -27.7%, respectively. There was no significant difference discovered in the phantom study between the RPM and Anzai, yet there was a meaningful difference in the patients' tumors (P<0.05). Conclusion The respiratory synchronized systems of RPM and Anzai yielded no significant difference in the phantom study in which the respiration was executed at regular intervals. However, it was discovered that the patients had a meaningful difference for the irregular respiratory cycle and inter-system differences. Still, the respiratory synchronized systems would be useful for the accurate diagnosis and SUV measurement as the tumor decreased in size against the existing Static and the SUV increased.